The impact of aid cuts and war on Somalia's deteriorating hospitals

MOGADISHU, Somalia In a desperate bid to save his severely malnourished 3-year-old son, farmer Yusuf Bulle journeyed from a remote southern Somali village to Mogadishu, where a specialized medical unit offered the only chance for survival. After 15 days at Banadir Hospital, the child was declared stable. In my village, there is no hospital, Bulle said. Thats why I had to come here.

Somalia, one of the worlds poorest nations, faces a deepening healthcare crisis, worsened by recent U.S. funding cuts from the Agency for International Development (USAID). The reduction in aid has left many Somalis skeptical of their government, which prioritizes military campaigns against the al-Qaida-linked group al-Shabab.

Deputy Health Minister Mohamed Hassan Bulaale explained that U.S. aid cuts resulted in more than 6,000 health workers losing employment and disrupted up to 2,000 medical facilitiesa severe setback in a country already vulnerable to donor withdrawal, according to the Center for Global Development.

While attacks by militants on health centers and other targets have decreased recently, some officials argue that the focus on defeating al-Shabab has come at the expense of essential public services. Somalias Ministry of Health received $91 million from a national budget exceeding $1 billion this year, largely allocated to donor-backed programs, an increase from $52 million last year. Mahad Wasuge of the Somali Public Agenda noted that such funding remains unpredictable.

Outside Mogadishu, many regions lack functional hospitals, forcing residents to navigate insecure areas for medical care. The capital hosts facilities like Banadir Hospital, supported by China since 1977, and De Martino Hospital, established by Italian colonists in 1922. Staff at these hospitals emphasized that much of their work depends on the United Nations and international aid groups.

At Banadir Hospital, the unit treating malnourished children relies entirely on funds from Concern Worldwide. After U.S. aid cuts led to the dismissal of 37 employees, the organization continues to pay 13 staff members and provides food and milk for mothers and infants, said Dr. Mohamed Haashi.

At De Martino Hospital, director Dr. Abdirahim Omar Amin expressed concern over the expiration of contracts with two humanitarian partners at the end of 2025. The hospital treats numerous children suffering from diphtheria, with routine vaccinations declining due to fear of militant attacks. Equipment in the lab was purchased with donor funds, and most services remain free thanks to organizations such as the International Rescue Committee and Population Services International. Patients with non-urgent conditions pay minimal fees.

Deputy Minister Bulaale stated that the government is collaborating with partners to develop contingency plans following the USAID withdrawal, though details remain limited.

De Martino Hospitals history reflects Somalias struggles. It once housed displaced people after the 1991 fall of dictator Siad Barre. Years of civil war destroyed many public facilities. The federal government, operating near Mogadishus airport with support from African Union peacekeepers, U.S. airstrikes, and foreign advisors, continues to face challenges asserting authority in a strategic region bordering the Indian Ocean and Gulf of Aden. Turkey also supports a hospital in the capital with intensive care capabilities.

Even the few public hospitals that are functioning depend heavily on donor funds, said Wasuge. Banadir and De Martino hospitals serve the most vulnerable populations, including COVID-19 patients during the pandemic. Residents like Amina Abdulkadir Mohamed rely on these hospitals for free care during childbirth.

Mohamed Adam Dini, representing Puntland in the national assembly, criticized the federal governments focus on security at the expense of healthcare. Diseases are spreading unchecked, Dini said. There is no national health care plan because we lack a national political plan.

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Analysis: Somalia's Healthcare Crisis Deepens Amid U.S. Aid Cuts

The healthcare situation in Somalia continues to deteriorate, with mounting challenges exacerbated by recent reductions in U.S. foreign aid. As one of the poorest countries in the world, Somalia’s already fragile healthcare system faces a critical turning point. In a desperate attempt to save his severely malnourished child, farmer Yusuf Bulle was forced to journey to the capital, Mogadishu, where the only viable medical care option was available. Unfortunately, this dire situation reflects a broader issue plaguing the country: inadequate healthcare infrastructure and a growing reliance on international support.

The cuts in U.S. aid, particularly from the U.S. Agency for International Development (USAID), have led to the loss of over 6,000 healthcare jobs and the closure of up to 2,000 medical facilities across Somalia. These cuts come at a time when the country is struggling to balance the fight against the al-Shabab militant group with its citizens' basic needs. The reduction in healthcare funding leaves vulnerable populations with little support, especially in rural areas where medical services are scarce. While the Somali government remains focused on military operations against al-Shabab, essential public services such as healthcare have suffered.

The situation is further complicated by a lack of predictable funding for Somalia’s Ministry of Health. Although there has been an increase in government allocation to the health sector this year, much of this funding is still dependent on external donors. Without continued international backing, Somalia’s healthcare system may collapse entirely, leaving the population without access to basic medical services. As a result, hospitals in Mogadishu like Banadir and De Martino, which serve the most vulnerable populations, remain reliant on foreign aid organizations like Concern Worldwide and the International Rescue Committee.

In summary, Somalia’s healthcare system is facing an unprecedented crisis, exacerbated by political and security priorities that overshadow the urgent needs of the population. While international organizations continue to provide vital support, the long-term sustainability of Somalia’s health sector remains uncertain without a reliable and independent funding structure. As the country grapples with these challenges, it is crucial for both the government and international partners to prioritize healthcare as a key component of the nation's recovery and future stability.

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• A visit to Somalia's crumbling hospitals shows the toll of aid cuts and war